Synopsis
Convert cancer-treatment history into a risk-based survivorship plan that detects recurrence and new malignancy appropriately, prevents avoidable late harm and restores physical, psychological, reproductive and social function.
- Survivorship begins at diagnosis and includes recurrence surveillance, late-effect prevention, new-cancer risk, rehabilitation, medicine review and support for identity, work, relationships and finances.
- First-line survivorship assessment uses an end-of-treatment summary: histology and stage, surgery, systemic agents and cumulative doses, radiotherapy fields and dose, transplant, complications, genetics and current medicines.
- A treatment summary should generate a personalised care plan naming surveillance, late-effect tests, vaccination, health-promotion actions, red flags, contact routes and ownership between specialist and primary care.
Key red flags
Progressive focal pain, unexplained weight loss, a new mass, bleeding or organ-specific alarm symptoms require investigation rather than attribution to survivorship anxiety.
Investigation priorities
Identify the exposures that determine surveillance and late-effect risk.
Management branches
A phase of curative or intensive cancer treatment ends.
- Provide the patient and primary care team with diagnosis, stage, treatments, cumulative exposures, toxicities, ongoing medicines, genetic findings and devices or altered anatomy.
- Convert each relevant exposure into a recurrence schedule, late-effect surveillance item, vaccination or prevention action, with exact owner and next date.
Key medicines
Long-term endocrine anticancer therapyContinue the tumour-specific tamoxifen, aromatase-inhibitor or androgen-deprivation regimen for the specialist-agreed duration, documenting exact agent, dose, start date, planned stop point and any treatment break.
Vaccination after cancer treatmentGive inactivated and live vaccines according to the current UKHSA Green Book schedule for immune recovery, splenectomy, transplant and ongoing immunosuppression; timing is exposure-specific rather than a universal post-chemotherapy date.